| NPI | 1710120696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAW M OO President 815-523-2070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036090542) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036090440) |
| 207R00000X Internal Medicine (Licence: IL 036108040) | |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2010-05-03 |